<label>Name:</label><input id="i_name" name="name" /><br />
<label>Age:</label><input id="i_age" name="age" /><br />
<label>Pick a color:</label>
<select id="i_color">
	<option>Red</option>
	<option>Green</option>
	<option>Blue</option>
</select><br />
<button onclick="Send()">Send</button>

<br /><br /><strong>Response:</strong><br />
<div id="response">
	Not was pushed.
</div>